- Document possible MH event in institutional chart. Add inhalational anesthetics (sevoflurane, desflurane, isoflurane) and succinylcholine to patient’s adverse drug reactions.
- Consult with MHAUS Hotline Consultant to determine if further testing is required to establish a diagnosis of MH susceptibility. (MHAUS Hotline 1-800-644-9737; outside the US, please call: 001-209-417-3722)
- MH clinical grading scale (Anesthesiology 1994)
- MH diagnostic muscle assay, the caffeine halothane contracture test (CHCT). Surgery for biopsy and CHCT must be done at an MH biopsy center. (Locations and Contacts)
- MH molecular genetic testing (More Information)
- Report acute MH event to the North American Malignant Hyperthermia Registry of MHAUS. (AMRA Report) Ask the patient to contact the Registry to sign consent if he/she wishes to link reported information with his/her name. (NAMHR Contacts)
- Obtain information about any prior personal or family history of anesthetic difficulties. Oftentimes, after an event, family members have additional recall of similar events in the family.
- Obtain information about any unusual responses to exercise or heat-stress including unexplained fevers, dark-colored urine, and/or severe muscle cramps.
- If positive, patient may need to be counseled to avoid exposure to severe exercise and heat stress and consider prescription of oral dantrolene. Discuss with MHAUS Hotline Consultant. (MHAUS Hotline 1-800-644-9737; outside the US, please call: 001-209-417-3722)
- Arrange for follow-up creatine kinase testing with primary care physician if still elevated at the time of discharge. Consider neurology referral.
- Refer the patient and family to MHAUS for further information. (Patient Liaison Committee)
- Sample letters to notify relatives of MH susceptibility
- Medical identification bracelets/necklaces through Medic-Alert*
- Emphasize importance of notifying health care providers in advance of elective procedures. (Sample letter)
* Suggested text for Medic-Alert* bracelet:
No Volatile Anesthetics/No Succinylcholine